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评估神经发育障碍儿科患者关节活动过度的新方法:一项初步研究。

A New Method to Evaluate Joint Hypermobility in Paediatric Patients with Neurodevelopmental Disorders: A Preliminary Study.

作者信息

Zoccante Leonardo, Ciceri Marco Luigi, Di Gennaro Gianfranco, Zaffanello Marco

机构信息

Childhood, Adolescence, Families and Family Health Center, Provincial Center for Autism Spectrum Disorders, 37122 Verona, Italy.

Science of Health Department, School of Medicine, Magna Graecia University of Catanzaro, 88100 Catanzaro, Italy.

出版信息

Children (Basel). 2024 Sep 23;11(9):1150. doi: 10.3390/children11091150.

Abstract

: Neurodevelopmental disorders (NDDs) include a wide range of conditions that develop during the formation of the central nervous system, such as autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD). Tourette syndrome (TS) is another neurodevelopmental disorder characterised by motor and vocal tics, which often co-occurs with ASD and ADHD. This study explores the feasibility of assessing joint hypermobility in children with specific neurodevelopmental conditions by measuring both ankles' passive range of motion (pROM). : This study involved children diagnosed with ASD, ADHD, and TS, aged 5 to 15 years, who were compared with a control group of healthy children. The Beighton and Brighton scores and the pROM of the left and right ankles were measured. Data were analysed using SPSS version 22.0 for Windows (IBM SPSS Statistics, Chicago, IL, USA). A total of 102 subjects participated in this study (72.52% male, with a mean age of 10.7 ± 2.2 years). The sample included 24 children with ASD, 27 with ADHD, 26 with TS, and 25 healthy controls. : The pROM of the right and left ankles showed a significant positive correlation with the Beighton and Brighton scores in children with NDDs (ASD, ADHD, and TS combined). A trend towards higher Beighton scores (≥6) was observed in the ADHD and TS groups, with significance found in the TS group ( = 0.013). The pROM of the right ankle was significantly higher in the ADHD ( = 0.021) and TS ( = 0.013) groups compared to the controls. Although the left ankle followed a similar trend in the TS group, the difference was not statistically significant ( = 0.066). Controlling for age, the diagnosis of ASD, ADHD, and TS does not appear to impact any of the variables examined. : There is a trend towards a higher prevalence of individuals with elevated Beighton scores in the ADHD and TS groups, suggesting greater general flexibility or hypermobility in these patients. However, the pROM of the right ankle is significantly higher in the ADHD and TS groups, with solid evidence in the TS group. These findings were not observed in children with ASD. However, it is necessary to consider the measurements obtained in relation to the patients' age. Finally, given that the pROM of the ankles correlates with the Beighton and Brighton scores, it could be utilised for the initial screening, monitoring, and follow-up of JH in some children with NDDs. Further investigations are required.

摘要

神经发育障碍(NDDs)包括在中枢神经系统形成过程中出现的一系列病症,如自闭症谱系障碍(ASD)和注意力缺陷多动障碍(ADHD)。抽动秽语综合征(TS)是另一种神经发育障碍,其特征为运动性和发声性抽动,常与ASD和ADHD共病。本研究通过测量双侧踝关节的被动活动范围(pROM),探讨评估特定神经发育病症患儿关节活动过度的可行性。

本研究纳入了年龄在5至15岁之间、被诊断为ASD、ADHD和TS的儿童,并与健康儿童对照组进行比较。测量了Beighton和Brighton评分以及左右踝关节的pROM。使用适用于Windows的SPSS 22.0版软件(IBM SPSS Statistics,美国伊利诺伊州芝加哥)对数据进行分析。共有102名受试者参与了本研究(男性占72.52%,平均年龄为10.7±2.2岁)。样本包括24名ASD患儿、27名ADHD患儿、26名TS患儿和25名健康对照。

在患有神经发育障碍(ASD、ADHD和TS合并)的儿童中,左右踝关节的pROM与Beighton和Brighton评分呈显著正相关。在ADHD和TS组中观察到Beighton评分有升高(≥6)的趋势,TS组具有显著性(P = 0.013)。与对照组相比,ADHD组(P = 0.021)和TS组(P = 0.013)的右踝关节pROM显著更高。虽然TS组左踝关节也有类似趋势,但差异无统计学意义(P = 0.066)。在控制年龄后,ASD、ADHD和TS的诊断似乎不影响所检查的任何变量。

在ADHD和TS组中,Beighton评分升高的个体患病率有增加趋势,提示这些患者具有更大的总体柔韧性或关节活动过度。然而,ADHD组和TS组的右踝关节pROM显著更高,TS组有确凿证据。在ASD患儿中未观察到这些结果。然而,有必要考虑与患者年龄相关的测量结果。最后,鉴于踝关节的pROM与Beighton和Brighton评分相关,它可用于一些神经发育障碍患儿关节活动过度的初步筛查、监测和随访。需要进一步研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0071/11430528/8d788744d4fc/children-11-01150-g001.jpg

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